TOPLINE

Anesthesiologists involved in perioperative catastrophes experienced substantial and enduring emotional consequences, with more than 90% reporting psychosocial symptoms and nearly three quarters reporting physical symptoms following such events. Many respondents perceived impaired ability to deliver anesthesia care after a catastrophic event, and nearly 20% reported never fully recovering emotionally.

METHODOLOGY

• A voluntary survey was distributed via email by the American Society of Anesthesiologists among US-based members in June 2025 to assess the emotional and physical consequences of perioperative catastrophes. A total of 1725 respondents (38.8% women; 73.1% White individuals) were included in the analysis.
• The 44-item survey instrument was adapted from a questionnaire developed in 2009, retaining core elements to preserve longitudinal comparability and adding items to assess perceptions of support modalities after the event.
• Participants reported perioperative catastrophes and documented their involvement, detailing the frequency of occurrences, clinical role, intraoperative mortality, and characteristics of a memorable event.
• Psychological and physical sequelae, effects on clinical performance, trajectories of recovery, and perceived institutional support were assessed.
• Respondents rated how the incident affected their anesthesia care delivery afterward. They documented the type of leaves (granted, requested, or self-initiated), duration of leaves, and perceived usefulness and reported on discussion with others and attendance at structured debriefings.

TAKEAWAY

• Overall, 94.2% of participants reported involvement in at least one perioperative catastrophe throughout their careers, with 35.1% experiencing two to three events and 16.9% experiencing over 10 events.
• After a memorable catastrophic event, 91.6% of respondents reported psychosocial symptoms including self-doubt (46.3%), grief (43.2%), loss of confidence (43.3%), and extreme sadness (38.1%); 72.5% reported physical symptoms such as sleep disturbances (54.5%) and muscle tension (38.8%).
• After an event, most respondents reported impairment in their ability to deliver anesthesia care during the initial 4 hours (69.0%) and 24 hours (61.5%); however, 97.2% received no institutionally sanctioned time off.
• Nearly one fifth (19.7%) of respondents stated they had not achieved complete emotional recovery following a perioperative catastrophe, and 23.3% reported that such an event led them to consider leaving anesthesiology.
• Among 1412 participants completing the opinion section, most endorsed structured support following perioperative catastrophic events. Top interventions were team debriefing (77.5%), informal discussions with colleagues (69.9%), and conversations with family (55.5%). Professional counseling (37.3%), peer support (43.3%), and confidential quality reviews (36.0%) were also deemed helpful.

IN PRACTICE

"[The study] findings highlight a persistent gap between cultural recognition of clinician distress and the structural supports provided in practice. Embedding routine, nonpunitive debriefing, accessible peer support, and flexible duty relief into standard perioperative operations represent pragmatic and necessary steps toward sustaining clinician well-being, patient safety, and workforce retention in high-acuity care environments," the researchers wrote.

SOURCE

The study was led by Rebecca Margolis, DO, of the Department of Anesthesiology Critical Care Medicine at the Children's Hospital Los Angeles/Keck School of Medicine in Los Angeles. It was published online on September 21 in Anesthesiology.

LIMITATIONS

The modified survey lacked independent pilot testing post-modification, potentially introducing measurement bias. Selection plus nonresponse bias posed limitations as clinicians most affected by perioperative catastrophes may have participated, possibly affecting symptom prevalence and support requirements. Electronic distribution allowed link sharing beyond American Society of Anesthesiologists membership; therefore, exact response rates remain undetermined.

DISCLOSURES

The study was supported by institutional and departmental sources. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.